All-on-Four Dental Implants

The All-on-Four Dental Implants technique was designed by Portuguese dentist Dr. Palo Malo to eliminate the need for expensive bone grafting. An implant dentist can use this system to place a full arch of teeth (excluding the molars) for a patient with low bone density.

How it Works

Highly angled implants are placed in the anterior of the jaw. This angled placement attempts to provide more stability to the denture when there isn’t enough bone present. This concept is demonstrated in the x-ray and diagram below.

X-ray of All-on-Four Technique

cleveland all on four dental implants

In this x-ray you can see how the angled implants are placed in the jaw.

Diagram of Procedure

all on four diagram

Pictured above is an illustration of this technique

Problems With This System

Some dentists, including a well-known national chain of dental implant clinics, put all-on-four implants in almost all their denture patients. However, there are risks involved, and Dr. Hylan believes in giving you the full story so you can make an informed decision about what you want in your mouth.

The all-on-four dental implants treatment has been criticized as being a shortcut. It is done as a way to avoid bone grafting, which has been the standard of care when a patient is missing a lot of bone. To compensate for not being able to use standard-sized implants to retain the overdenture, the implants are placed at sharp angles, which is supposed to make it more difficult for them to be dislodged. But there are risks. First, the system places a lot of stress on implant fixtures which, because of the lack of bone, have to be smaller than conventional implants. Second, if one of the four dental implants fails, all of the stress then has to be absorbed by the three remaining implants. This is more than they can handle and results in the failure of the entire system.

All-on-Six Dental Implants

One way around these risks is to add two implants and do an all-on-six procedure. These two extra implants provide increased stability and an added measure of safety. Dr. Hylan prefers this option, rather than all-on-four. But he will explain the costs, the risks and expected benefits, and not pressure you into choosing one option or another. Bone grafting does add expense and a lengthy time delay in receiving your teeth. You need to decide if the difference in stability and risk is worth the delay for you.

Bone atrophy is another concern when using the all-on-four treatment. When you are missing teeth, your body resorbs the bone and minerals to be used elsewhere. Dental implants prevent bone resorption and stimulate new growth. Since the four implants are only placed in the anterior portion of the jaw, this leaves other areas at risk for weakening, shrinkage, and fracture. To learn more about this condition, please visit our page on facial collapse.

We would be happy to meet with you for a consultation to help you determine if you are a candidate for this dental implant system and answer any questions you may have. Give us a call at 855-876-6100 for new patients, or you can request an appointment online, by clicking on our request an appointment page.